Active NPI
Lourdes Villacis, D.O.
- Psychiatry Physician
- Bethesda, MD
National Provider Identifier
1578631636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- H0062196
- Practice address
- 8901 Wisconsing Ave
Building 10, # 7125
Bethesda, MD 20889 - Phone
- (301) 400-0492
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | H0062196 | MD | Primary |
Addresses
Primary practice location
8901 Wisconsing Ave
Building 10, # 7125
Bethesda, MD 20889
Mailing address
8901 Wisconsin Ave
Building 10, 7TH Floor, #7125
Bethesda, MD 20889
Phone (301) 400-0492
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H0062196 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0062196 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1578631636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8901 WISCONSIN AVE",
"address_2": "BUILDING 10, 7TH FLOOR, #7125",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20889",
"telephone_number": "301-400-0492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 WISCONSING AVE",
"address_2": "BUILDING 10, # 7125",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20889",
"telephone_number": "301-400-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLACIS",
"first_name": "LOURDES",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "H0062196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H0062196",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.